经尿道选择性绿激光汽化术与电切术治疗前列腺增生的价值比较

目的探讨经尿道选择性绿激光前列腺汽化术（PVP）治疗前列腺增生的安全性和疗效以及与经尿道前列腺电切术（TURP）相比的优势。方法对我院2003年10月—2007年9月行经尿道选择性绿激光汽化术患者75例（PVP组）及同期行经尿道前列腺电切术（TURP组,对照组）患者53例的临床资料（年龄,病程、术前IPSS、术前最大尿流率,术前残余尿、前列腺质量）、手术情况（手术时间,术后输血,术后尿管留置时间,术后住院时间）、疗效（术后最大尿流率,术后IPSS）等指标进行比较分析。结果两组年龄、病程、术前IPSS评分、术前最大尿流率、术前残余尿量等项指标之间的差异均无统计学意义（P〉0.05）。PVP组前列腺质量（60.715±30.253）g,小于TURP组的（71.580±28.914）g（P=0.012 9）。两组手术后的IPSS以及最大尿流率较术前明显改善（P〈0.01）;而两组内手术前后的IPSS及最大尿流率比较,差异无统计学意义（P〉0.05）。平均手术时间、术后输血、术后尿管留置时间、术后住院时间两组比较差异有统计学意义（P〈0.05或P〈0.01）。结论经尿道选择性绿激光汽化技术安全、疗效可靠,与传统的电切手术相比具有明显的优势,临床应用前景广阔。

The value comparison between green laser photoselective vaporization of prostate and electrocision for benign prostatic enlargement

Objective To investigate the safety,curative effect and advantages of green laser photoselective vaporization of prostate（PVP） compared to transurethral resection of the prostate（TURP）.Methods From October 2003 to September 2007,PVP and TURP were performed in 75 and 53 cases respectively.All the patients were divided into 2 groups according to operation： group PVP（n=75） and group TURP（n=53）.The indexes were compared including age,time of disease,IPSS of pre-operation,Qmax of pre-operation,the volume of residual urine,the weight of prostate,operation time,blood transfusion post-operation,ureter time,hospital stay,Qmax of post-operation and IPSS of post-operation.Results There were no statistic difference of the age of patients,time of disease,IPSS pre-operation,Qmax pre-operation and the volume of residual urine between the two groups（P〉0.05）.The prostate of group PVP was（60.715±30.253）g,that was significantly lower than group TURP [（71.580±28.914）g,P=0.0129].IPSS and Qmax post-operation in both two groups were significantly improved comparing with pre-operation（P0.05）.there was no statistic difference of operation time,blood transfusion,ureter time,hospital stay post-operation between the two groups（P〈0.01）.Conclusion PVP is safe and effective enough to cure benign prostatic enlargement.And PVP has some advantages which TURP has not.